Testin Research Articles

PRESSURE FLOW ANALYSIS MAY AID IN IDENTIFYING WOMEN WITH OUTFLOW OBSTRUCTION

We refined recently developed pressure flow cutoff values for female bladder outlet obstruction and applied these values in a consecutive group of women undergoing urodynamic testing for various lower urinary tract symptoms. A total of 87 women with clinical obstruction determined by history and presenting complaint were enrolled in our prospective evaluation of pressure flow studies. We identified 3 groups of participants according to the suspected cause of obstruction, including prolapse in 33, previous incontinence surgery in 25, and no likely source of obstruction identified from history and physical examination only in 29. An additional 124 patients presenting for evaluation of stress urinary incontinence served as controls. Optimal cutoff values for determining obstruction were developed using receiver operating characteristic curves. To determine the prevalence of bladder outlet obstruction these values were prospectively applied to 106 women undergoing urodynamics for various voiding complaints. In controls the average maximum flow rate was 23 cc per second and average detrusor pressure was 21.9 cm. water, whereas the corresponding values in those with clinical obstruction were 10.7 cc per second and 40.8 cm. water (p <0.001). No differences were noted in the various obstruction groups. Receiver operating characteristics analysis revealed that cutoff values of 11 cc per second or less and 21 cm. water or more optimized the selection of patients with bladder outlet obstruction. Using these values we noted a bladder outlet obstruction prevalence of 20% in a consecutive cohort of women undergoing urodynamic studies at our center. We propose cutoff pressure flow values for identifying women with bladder outlet obstruction although they should be used only in conjunction with the overall clinical situation. Neither pressure flow data only nor clinical symptoms alone may be sufficient for diagnosing obstruction in women.

SENSITIVITY OF HUMAN COMPLEMENT FACTOR H RELATED PROTEIN (BTA STAT) TEST AND VOIDED URINE CYTOLOGY IN THE DIAGNOSIS OF BLADDER CANCER

We compared the sensitivity of the BTA statdagger test, a rapid, noninvasive, qualitative urine test that detects bladder tumor associated antigen (human complement factor H related protein) in urine, to that of voided urine cytology in patients with primary bladder cancer. We also assessed the effect of tumor size, number, histological grade and stage on test sensitivity. We evaluated 151 patients with newly diagnosed bladder cancer in a prospective multicenter study. A voided urine sample obtained before transurethral bladder tumor resection was divided for culture, cytology and BTA stat testing. Overall sensitivity of the BTA stat test and urine cytology for detecting primary bladder cancer was 81.5% and 30.3%, respectively (p <0.0001). The sensitivity of each test increased as tumor size, number, histological grade and stage increased. Sensitivity of the BTA stat test was superior to that of voided urine cytology in all tumor categories. This noninvasive, easy to perform, point of care test may have the potential to replace cytology for diagnosing bladder cancer.

DIAGNOSING BLADDER OUTLET OBSTRUCTION IN WOMEN

There are no universally accepted urodynamic criteria for diagnosing female bladder outlet obstruction. When accepted criteria for men are applied to women, the diagnosis of obstruction may often be missed, which is most likely due to differences in voiding dynamics. We propose video urodynamic criteria for diagnosing obstruction in women, and describe the urodynamic findings in those with and without obstruction. We reviewed the charts of 331 women who underwent multichannel video urodynamics for nonneurogenic voiding dysfunction. Of these women 261 (mean age 55.8 years) had evaluable voiding pressure flow studies with simultaneous video fluoroscopy of the bladder outlet during voiding. At video urodynamics cases were classified as obstructed if there was radiographic evidence of obstruction between the bladder neck and distal urethra in the presence of a sustained detrusor contraction. Strict pressure flow criteria were not used. Maximum flow rate, detrusor pressure at maximum flow rate, post-void residual, bladder capacity and the incidence of detrusor instability were compared between obstructed and unobstructed cases. A total of 76 women met the criteria for obstruction (mean age 57.5 years), while 184 (mean age 55) did not. Causes of obstruction were dysfunctional voiding in 25 cases, cystocele in 21, primary bladder neck obstruction in 12, iatrogenic from incontinence surgery in 11, urethral stricture in 3, uterine prolapse in 2, urethral diverticulum in 1 and rectocele in 1. Obstructed cases had lower mean maximum flow rate (9 versus 20.2 ml. per second, p <0.0001), higher mean detrusor pressure at maximum flow rate (42.8 versus 22.1 cm. water, p <0.0001) and higher mean post-void residual (157 versus 33 ml., p <0.0001). There was no difference in bladder capacity (381 versus 347 ml.) or incidence of detrusor instability (45 versus 41%). Using the proposed video urodynamic criteria obstructed cases had significantly higher voiding pressures, lower flow rates and higher post-void residual than unobstructed cases, as expected. However, absolute values, especially for voiding pressure, are not as dramatic in women as in men. Pressure flow studies alone may fail to diagnose obstruction but simultaneous imaging of the bladder outlet during voiding greatly facilitates diagnosis.

FINISH LINE FATIGUE IN TRIATHLON - AN EXERCISE IN DIFFERENTIALS

1729 HISTORY - LF, a 30 yo WF high level triathlete, presented to the finish line of an Olympic Distance Championship Triathlon disoriented and unable to ambulate further without assistance. She was immediately supported, but after several steps was unable to ambulate further. She was subsequently carried immediately to the finish line medical tent. Ambient Weather: Wet Bulb Globe Temperature 81 F.; Sunny skies with haze; minimal breeze. PHYSICAL EXAMINATION: Temp. (rectal) Deferred (agitation). HR: 150. R: 30, deep. BP 110/60. Skin was warm and moist (sweaty); Turgor: Fair. MS: Awake, confused, agitated; Oriented to person, season, month; Monosyllabic. Exercise Associated Collapse Exertional Hyperthermia Dehydration INITIAL TREATMENT & FOLLOW UP: Six-point ice packs; free-flow garden hose. Two liters of normal saline given intravenously. Mental status steadily improved; HR steadily normalized. Began to take oral fluids; eventually able to ambulate unassisted. Conversation lucid and appropriate. Voided clear yellow urine. LF, a resident physician, was discharged to the care of family and friends. Subsequent to release from the Medical Tent, LF returned home, continued with dry heaves, developed frequent watery diarrhea, remained fatigued, and did not void again. She proceeded to the Emergency Room after 3 hours. Persistent Dehydration Rhabdomyolysis Acute Renal Failure / Acute Tubular Necrosis (?)Hyponatremia (?)Bowel Ischemia TEST & RESULTS IN ER: LABS: WBC = 30.45 with Left Shift; Hgb 12.9; CPK 744; Na 142, K 3.9, Cl 111, CO2 20, BUN 20, Cr 1.7; UA: Yellow, Clear, SpG 1.020, pH 5.0, Keto 15; Myoglobin - NEG. CXR: Bibasilar atelectasis/infiltrate; B/L pleural effusions. WORKING DIAGNOSIS: Dehydration; Mycoplasma pneumonia. 10-12 L NS given in ER Azithromycin LAB FOLLOW UP: Legionella: Negative. Mycoplasma: Negative (CF 1:8). Exertional Heat Injury with Dehydration & Mild Acidosis. Viral vs Other Bacterial pneumonia vs Pulmonary Congestion (Fluid Overload) Other Potential Underlying / Precipitating Process(es) • Leptospirosis; Overtraining Syndrome; Anemia vs "Sports Anemia"

NONINVASIVE DETECTION OF BLADDER CANCER WITH THE BTA STAT TEST

We assess the sensitivity and specificity of the noninvasive BTA stat urine test for detection of primary and recurrent bladder cancer with special reference to the size, grade and stage of the tumors, and examine the effect of intravesical bacillus Calmette-Guerin treatment on the results. A total of 250 patients recruited from 3 medical centers provided voided urine samples for the BTA stat test and cytopathological study. Of these patients 162 were monitored following resection of bladder tumors and 88 were evaluated for the first time for hematuria or irritative voiding symptoms. Each patient underwent cystoscopy. Biopsies were obtained when a bladder tumor was seen or if carcinoma in situ was suspected. The sensitivity, specificity and accuracy of the BTA stat test were compared to standard voided urine cytology. No tumor was found in 122 patients, primary transitional cell carcinoma was found in 71 and cystoscopy revealed recurrent tumors in 57. Overall sensitivity of the BTA stat test was 82.8% and specificity was 68.9%. Sensitivity of urine cytology was 39.8% and specificity was 95.1%. The BTA stat test detected 90.1% of the primary and 73.7% of the recurrent tumors. All patients with carcinoma in situ, high grade tumors, muscle invasive cancer and tumors larger than 2 cm. were diagnosed by the BTA stat test. The BTA stat test can be used as a screening test for bladder cancer in patients with hematuria or irritative voiding symptoms and for surveillance of those who have not been treated with intravesical bacillus Calmette-Guerin.

EVALUATING DIAGNOSTIC TESTS IN THE PLEURAL SPACE: Differentiating Transudates from Exudates as a Model

Physicians have a staggering variety of diagnostic tests available for directing their diagnostic and therapeutic decisions. Technologic advances in laboratory science have increased the sophistication of new tests and accelerated their rate of adoption into clinical practice. Unfortunately, studies that report the value of new diagnostic tests often fail to follow accepted methodologic standards for unbiased test assessment or provide clinicians with sufficient information for the intelligent evaluation of a test's performance and applicability. The following review of pleural fluid tests that discriminate between exudative and transudative effusions serves to highlight important methodologic considerations in the assessment of diagnostic tests.

Standardization of the Panga Munthu Test-A Nonverbal Cognitive Test Developed in Zambia

The relationship between intelligence measurement and culture has received growing recognition in Zambia since political independence. The Panga Munthu Test (PMT) was developed to provide a more accurate and culturally appropriate assessment of intelligence for children in a non-Western society. This article describes the test's rationale, its administration and scoring procedures, and progress toward its standardization in Zambia. Scores of a large, nationwide sample of children are presented and their variations analyzed by age, grade, gender, and residence (urban versus rural). Two complementary approaches are offered for arriving at reference norms to guide the interpretation of individual scores. The implications for future test development and individual assessment of intellectual functioning in primary school-aged children in Africa are discussed. USES AND PROBLEMS OF COGNITIVE TESTING IN AFRICA Structured tests of cognitive functioning are probably the most widely marketed product of applied developmental psychology. Yet, despite their technical sophistication, the most widely known of those tests, which claim to provide an objective index of general intelligence (or IQ), are often the targets of severe criticism. In Africa, the focus of such criticism most often centers on the likelihood of cultural bias. Though these tests' predictive validity may appear to be supported by evidence of their correlation with school achievement in Africa, this may only reflect a process of circular corroboration. The school curricula into which African students showing the greatest academic aptitude are selected are heavily saturated with the Western cultural orientation that informs both the form and the content of the tests (Serpell, 1974, 1984). Indeed, the very concept of intelligence is so deeply embedded in a complex network of interdependencies among the values, practices, and technology of Western culture that it may well be counterproductive to seek a culture-free definition of what it means, let alone a culture-fair measure of its manifestation (Berry, 1974; Sternberg, 1984). Discussions with indigenous informants in several rural African communities have led many researchers to conclude that the terminology used for the evaluation of intellectual functioning does not map in a simple one-to-one correspondence with Western ideas about this domain (Bissiliat, Laya, Pierre, & Pidoux, 1967; Dasen et al., 1985; Serpell, 1974, 1977; Wober, 1974). For instance, among the Chewa people of Zambia, the search for an understanding of the concept of intelligence may be both different from, and perhaps less important than, the search for an understanding of nzelu, a term used to represent several aspects of personality, including cognitive alacrity, social responsibility, and wisdom, in ways that only partially overlap with the English concept of intelligence (Serpell, 1993). Nevertheless, an objectively reliable method for assessing the general intellectual competence of an individual would be a valuable resource for a number of socially significant activities in the contemporary world. In the context of mental health services, professional psychologists are routinely requested for an estimate of a patient's intelligence as an important ingredient for the process of clinical diagnosis. Among the several defining characteristics of the condition known as mental retardation (or severe intellectual disability) is a general weakness in learning new tasks (Serpell et al., 1988). In the field of education, psychologists often base their advice to teachers and parents on the consistency (or lack thereof) between the general intelligence of a student and his or her level of performance on academic tasks. A child who is intelligent, yet not performing well at school probably has different needs than a less intelligent child obtaining similar grades in class. In addition to these routine applications of intelligence testing in professional applied psychology and education, researchers often find it relevant to inquire about the relationship between intelligence and other aspects of behavior. …

THE RELATIONSHIP BETWEEN OXYGEN SATURATION AND DYSPNEA DURING A SIX MINUTE WALK TEST IN PATIENTS WITH COPD.

S OF PLATFORM AND POSTER PRESENTATIONS: 1999 CSM Seattle, Washington: PLATFORM PRESENTATIONS: PDF Only

A REVIEW OF CONCURRENT AMBIENT WATER COLUMN AND SEDIMENT TOXICITY TESTING IN THE CHESAPEAKE BAY WATERSHED: 1990–1994

A REVIEW OF CONCURRENT AMBIENT WATER COLUMN AND SEDIMENT TOXICITY TESTING IN THE CHESAPEAKE BAY WATERSHED: 1990–1994

PLACEMENT TESTING IN COMMUNITY COLLEGES

(1995). PLACEMENT TESTING IN COMMUNITY COLLEGES. Community College Journal of Research and Practice: Vol. 19, No. 6, pp. 585-589.

EXERCISE TESTING IN SELECTED PATIENT GROUPS: Women, the Elderly, and the Asymptomatic

Exercise testing for coronary artery disease (CAD) has been validated primarily for middle-aged men. For women and the elderly, full assessment of individual risk and estimation of the pre-test likelihood of CAD is important before deciding to perform an exercise study. Negative electrocardiographic (ECG) findings with an exercise test in women and the elderly are predictive of good prognosis and low risk of cardiovascular events. Positive ECG findings may be falsely positive, and additional testing, nuclear or echocardiographic imaging, or coronary angiography may be indicated. Consensus guidelines are not yet available for testing in asymptomatic patients with exercise, and individual management decisions are still required.

Oral Concurrent Session F OB Anesthesia and Pharmacology Medical Complications of Pregnancy

Oral Concurrent Session F OB Anesthesia and Pharmacology Medical Complications of Pregnancy

AN APPLICATION OF MULTIMEDIA SOFTWARE TO STANDARDIZED TESTING IN MUSIC

This project explored the possible applications of new technology to standardized testing. Because the multimedia approach is particularly promising for music, the Graduate Record Examination (GRE) music test was chosen as the context for this project. The basic system for administering the test and recording the results was written using Multimedia Toolbook (TM) software by Asymetrix and other programs. The test was designed to replicate some parts of the current GRE music test and to introduce aural questions not currently testable in a paper and pencil format, such as recognition of intervals and chords. The developed teat was pilot tested twice in 1992 with 27 and 70 test takers, respectively, all music students with varying amounts of training. A scoring algorithm was developed to simulate expert human judgment of a particular response. The difficulties inherent in test development, administration, and scoring make it apparent that standardized tests using multimedia software need much more development before they can be implemented. Significant resources must be devoted to this cevelopment, but such tests could be possible within the next 5 to 10 years if the personal and financial commitments are made. Four appendixes contain the computer screens of the experimental test, the test taker questionnaire, a presentation of performance data (13 tables), and 2 tables of validity data. (SLD) *********************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. *********************************************************************** R E S E A R C H E O R T U S DEPARTMENT Of EDUCATION Once of Educauonai RItaot and Improvement EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) rue document nee bean reproduced as tecen,ed trom tne Demon or ,eependaPon ongtnat.ng C Mnot changes nave Coon mad* to .rnotov teptoductton oolooy Pcnts of new 01 optmOnS stated .0 INS dOCumen! Oo not nCeSatny reprosant oNrcral 0E141 000.11On Or policy 'PERMISSION TO REPRODUCE THIS MATERIAL HAS BEEN GRANTED BY BR/9m TO THE EDUCATIONAL RESOURCES INFORMATION CENTER IERICI RR-93-36 AN APPLICATION OF MULTIMEDIA SOFTWARE TO STANDARDIZED TESTING IN MUSIC Mari Pearlman Ken Berger Linda Tyler Educational Testing Service Princeton, New Jersey August 1993

RANKING, ESTIMATION AND HYPOTHESIS TESTING IN UNBALANCED TWO-WAY ADDITIVE MODELS - A BAYESIAN APPROACH

Article RANKING, ESTIMATION AND HYPOTHESIS TESTING IN UNBALANCED TWO-WAY ADDITIVE MODELS - A BAYESIAN APPROACH was published on January 1, 1993 in the journal Statistics & Risk Modeling (volume 11, issue 1).

NIH Panel OK's Vaccine Test-in a New Form

NIH Panel OK's Vaccine Test-in a New Form

A Developmental Psycholinguistic Approach to Second Language Teaching

Series Editor's Introduction THE THEORETICAL FRAMEWORK A PRAGMATIC VIEW: COMMUNICATIVE INTENTIONS The Nature of Communicative Intentions Categorizing Communicative Intentions Communicative Intentions in Schools FROM WORDS TO SENTENCES The First Step Towards Sentences: Vertical Constructions Towards the Nuclear Sentence Towards the Mastery of Other Sentence Structures The Sequence of Sentence Acquisition in Italian Children and German Children Sentence Structures at School. Lexical Development First Words at School THE ACQUISITION OF SOME MORPHOSYNTACTICAL ELEMENTS First Speech, Then Grammar The Beginning of Morphosyntax Morphosyntax Morphosyntax at School EDUCATIONAL PSYCHOLOGY AND SECOND LANGUAGE TEACHING Educational Goals. Interaction in the School Setting Group Work EXPERIMENTATION ACTIVITIES IN THE CLASSROOM Games of Let's Pretend The Pragmatic Basis of Language Other Games Teaching Formats Concluding Comments THE INTERVIEW AND ACHIEVEMENT TESTS IN SECOND LANGUAGE The Interview The Results of the Interview Results Obtained in the Achievement Tests in Second Language at the End of the First Teaching Year (Third Grade) Results Obtained in Second Language Tests at the End of the Second Teaching Year (Fourth Grade) The Analysis of Some Morphosyntactic Aspects Results of the Second Language Test at the End of the Third Teaching Year (Fifth Grade) Concluding Comments Conclusion References Author Index Subject Index

Book reviews

Book reviewed in this article:A TEXTBOOK AND COLOUR ATLAS OF THE TEMPOROMANDIBULAR JOINT, edited by John Edgar deBurgh Norman and Sir Paul Bramley.DIAGNOSTIC PICTURE TESTS IN PAEDIATRIC DENTISTRY, by W.P. Rock, Margaret C. Grundy, and Linda Shaw.NEW FRONTIERS IN FLUORIDE STUDIES FOR HEALTH. Proceedings of an International Workshop on Fluoride and Dental Health, 5–8 January 1987, Madras, India, edited by A.J. Rugg‐Gunn and Mohammed Rahamatulla.GUIDE TO PERIODONTICS, by W. M. M. Jenkins, C. J. Allan, and W. J. N. Collins.DENTAL RADIOGRAPHY, by N. J. D. Smith.LIFE THREATENING EMERGENCIES IN DENTISTRY, by V. Chilo, G. Borea, M. E. Strong, and translated by R. A. Collinsplatt.THE MOUTH AND PERIORAL TISSUES, edited by Crispian Scully.ENDODONTIC RADIOGRAPHY: PRINCIPLES AND CLINICAL TECHNIQUES, by Steven A. Cohn.DISEASE DRUGS AND THE DENTIST, by Humphrey D. Astley Hope and Michael D. Hellier.

WORKER ATTITUDES AND THE COST OF PRODUCTION: HYPOTHESIS TESTS IN AN EQUILIBRIUM MODEL

WORKER ATTITUDES AND THE COST OF PRODUCTION: HYPOTHESIS TESTS IN AN EQUILIBRIUM MODEL I. INTRODUCTION U.S. labor productivity growth, resulting in a tripling of real GNP from the end of World War II to 1973, began to slow down in the mid-1960s and continued to slow throughout the 1970s. By the decade of the 1980s, productivity growth as measured by the U.S. Department of Labor's Office of Productivity and Technology had fallen from the 3.5 percent annual levels of the previous two decades to less than 1 percent per year. A number of authors have tried to link worker morale and attitudes to labor productivity. Katz, Kochan, and Gobielle [1984] seek to attribute declines in labor efficiency (as they measure it) and product quality to deterioration in labor morale as measured by the frequency of grievances, disciplinary actions, absenteeism, contract disputes, and by the general climate of worker-employer relations at the plant leve. Weisskopf, Bowles, and Gordon [1984] attribute the slowdown to a decline in labor input per hour of purchased labor. They use a single equation macroeconomic model of aggregate production for the U.S. This paper introduces an index of worker attitude constructed from various indicators, and estimates the effect of changes in this index on three measures of economic growth performance: labor productivity, multifactor productivity, and the costs of production. The study is based on the automobile industry in the United States. The model includes all purchased inputs, rather than the Katz, Kochan, and Gobielle _1984] and Weisskopf, Bowles, and Gordon [1984] approaches that studied labor productivity in isolation. Cost functions and input cost-share equations are estimated simultaneously. This procedure eliminates single-equation sensitivity to small changes in specification, and corrects for use of other inputs with labor. A major contribution of this paper is the simultaneous estimation of the index of worker attitude and its effects on production. The result is an index of worker attitude that is based on effective attitude measures as evidenced by slower productivity rather than a measure of worker attitudes taken from direct surveys of the workers. Such surveys may or may not measure an index of attitudes, because the attitudes measured may not lead to slower production. Statistical results (see Norsworthy and Zabala [1985a; 1985b]) are very strong and consistent with the neoclassical theory of production, and the attitude indicators are similar to those discussed in Zabala [1983]. The fact that these models perform in a similar fashion at different levels of aggregation is persuasive evidence. Major U.S. industries are performing better now than in recent times of economic recession, but many are operating at lower levels of production and with substantially smaller labor forces than in recent periods of prosperity. Competition from western Europe and Japan is extremely strong in both foreign and domestic markets. The results in this paper suggest strongly that U.S. industry could be made significantly more competitive by improved human resource management. The following two hypotheses concerning attitudes on productivity and costs are tested: first, that worker attitudes have no effect on the cost of production; second, that the effects of worker attitude are factor neutral, having no effect on the relative efficiencies of capital, production-worker labor, nonproduction labor, and materials. Each of these hypotheses is tested in the context of two translog cost function models with alternate factor-share equations omitted. Finally, the attitude indexes derived from the factor-neutral and factor-bias models are found to have similar properties and to be strongly correlated through time. There are also plausible correlations with labor productivity, total factor productivity, and the total unit cost of production. …

Book reviews

FLUORIDE IN DENTISTRY, edited by Jan Ekstrand, Ole Fejerskov and Leon M. SilverstonePRINCIPLES OF DENTAL PUBLIC HEALTH, by James Morse DunningDIAGNOSIS AND TREATMENT PLANNING IN DENTOFACIAL ORTHODONTICS, by Frans P.G.M. van der Linden and Herman BoersmaGLASS‐IONOMER CEMENT, by Alan D. Wilson and John W. McLeanTHE AIDS MANUAL, compiled by Albion Street (AIDS) CentrePARTIAL DENTURE DESIGN: A LINGUAL LOCKING APPROACH, by Robert A. KatsevPEDIATRIC DENTISTRY: Total patient care, by Stephen H. Y. WeiDENTAL MANAGEMENT OF THE MEDICALLY COMPROMISED PATIENT, by James W. Little and Donald A. FalacePORCELAIN LAMINATE VENEERS, by David A. Garber, Ronald E. Goldstein, and Ronald A. FeinmanDENTAL SURGERY ASSISTANTS' HANDBOOK, edited by R. G. SmithA GUIDE TO DENTAL RADIOGRAPHY, 3rd edn. DENTAL PRACTITIONER HANDBOOK No. 27, by Rita A. MasonDIAGNOSTIC PICTURE TESTS IN DENTISTRY, by P‐J Lamey and M.A.O Lewis

Book Review

Book Reviewed in this Article:COMMON PROBLEMS IN PEDIATRIC SPORTS MEDICINE, by N. J. SmithINTRAUTERINE GROWTH RETARDATION: A PRACTICAL APPROACH, by T. L. Gross and R. J. SokolTHE CHILD WITH FEBRILE SEIZURES, by S. J. WallaceINTERNATIONAL INCIDENCE OF CHILDHOOD CANCER, edited by D. M. Parkin, C. A. Stiller, G. J. Draper, C. A. Bieber, B. Terracini and J. L. YoungDIAGNOSTIC PICTURE TESTS IN PAEDIATRIC DENTISTRY, by W. P. Rock, M. McGruncy and L. ShawCONTRIBUTIONS TO NEPHROLOGY, VOL. 67: PAEDIATRIC NEPHROLOGY: A RESEARCH UPDATE, by D. Boda and S. TuriTHE SUPPORTIVE CARE OF THE CHILD WITH CANCER, by A. Oakhill; 1988. London, England: John WrightHUMAN GROWTH HORMONE: PROGRESS AND CHALLENGES, edited by L. E. UnderwoodCLINICAL PEDIATRIC OTOLARYNGOLOGY, by T. Balkany and N. Pashley; 1987. USA: CV Mosby